Provider Demographics
NPI:1134620164
Name:ADVANCED CRITICAL CARE LUNG AND SLEEP, LLC
Entity type:Organization
Organization Name:ADVANCED CRITICAL CARE LUNG AND SLEEP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SADIQ
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-NAKEEB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-810-0677
Mailing Address - Street 1:2430 VANDERBILT BEACH RD STE 108
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2654
Mailing Address - Country:US
Mailing Address - Phone:239-810-0677
Mailing Address - Fax:239-920-4447
Practice Address - Street 1:6101 PINE RIDGE RD FL 3
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119
Practice Address - Country:US
Practice Address - Phone:239-920-4446
Practice Address - Fax:239-920-4447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-25
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty